By Janet D. Segall
IPPF Director of Patient Services
I wanted to write this article because in the last few years I have learned a lot about C-Reactive Protein which could be very important to many of us.
In 1969, when I was in my early 20‘s, my father woke up one morning and died. This was a very devastating chapter in my life. My father and I were very close and his death shook me to my core. Unfortunately, times being what they were, we never had an autopsy ,but we all assumed he had a typical massive heart attack. Being female, I was not concerned that I would have a heart attack, but my brother did and had every heart test available. He was in his late 20’s and, of course, he was fine.
Two years ago, at the age of 61, my brother, Paul, woke up one morning and died. But, with times being what they are now, we knew that what he died from was called an aortic dissection. The main artery from his heart to his brain tore. He wasn’t in much pain, but he collapsed because the blood from his heart could not flow to his brain.
Several years prior to my brother’s death, he developed ulcerative colitis. He was on prednisone and 6MP which is like Imuran. We know that in our family we have the autoimmune gene because of his colitis, my pemphigus, and several other autoimmune diseases in my family. But, we didn’t know a lot about cardio-vascular disease. My mother is 85, and in great shape. She even still works part-time. I have 3 brothers (2 now). We thought we were safe. We all watched our cholesterol and HDL and LDL numbers making sure our ratio’s were below 4. That is a good score - high HDL, low LDL’s. My brother thought, "I’m eating right. I have a good score; maybe just a little plaque I have to watch out for."
At an American Academy of Dermatology meeting, before my brother died, I was talking with a doctor who was head of a prestigious university's Dermatology Department. He had just lived through a heart attack. I started to tell him that my father had died at 56 from a massive heart attack and my siblings and I were a little nervous as we were getting older. The one thing he said that really caught my attention was, "Have your C-Reactive Protein checked. That could help tell you whether you might be at risk for a vascular disease."
I decided to do as this doctor suggested and had my C-Reactive Protein tested. I tested negative. A sigh of relief. I told my brothers to have themselves tested and both of my older brothers did. My brother Paul tested very high. Within 6 months of that test, he died.
With the last two years, I have heard more and more about C-Reactive Protein being a precursor to cardio-vascular disease. A person who has autoimmune disease and/or is taking prednisone can have a high C-Reactive Protein test because it tests inflammation. My brother said, "I’ll go for a cardio test, but I have colitis and I’m on prednisone so that is why the test is high." (He was also a Ph.D. in biology so he knew his science.)
C-reactive protein (CRP) is a special type of protein produced by the liver that is only present during episodes of acute inflammation. Although the role of CRP in coronary artery disease remains unclear, it has been suggested that testing CRP levels in the blood may be a new way to assess cardiovascular disease risk. A high sensitivity test is now widely available. It is not known whether it is merely a marker of disease or whether it actually plays a role in causing atherosclerotic disease. Many consider elevated CRP to be a positive risk factor for coronary artery disease.
My brother was right in thinking that his CRP might be high only because he had autoimmune disease. But, because our father died of heart disease, doing tests to make sure his heart and arteries were okay, seemed reasonable. Unfortunately, it was too late for him.
In the May issue of Prevention Magazine, there is an article on vascular disease. Paul’s heart surgeon recommended that the rest of the family have an echo cardiogram performed to test heart arteries. A recent report suggested that vascular disease is more likely in siblings then if a parent only had it. There are several centers in the U.S. that will be giving free sonograms to people potentially at risk for cardiovascular disease.
I am not trying to scare anyone, but we all should have our CRP checked. It could just be that a high score means an autoimmune disease, but check it out. It isn’t just because of my brother. A pemphigus patient called me recently who had a high-CRP level, and caught his vascular disease in time. But I had never forgot what the doctor at the AAD meeting had told me, and I wanted to share his concerns and mine with all of you. Sources:
http://www.nlm.nih.gov/medlineplus/ency/article/003356.htm
http://www.americanheart.org/presenter.jhtml?identifier=4648
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